If you have a query please email our mailbox or call our phone line on 01926 65 5300 which is open 9AM to 12PM and 1PM to 4.30PM Monday to Thursday and 9AM to 12PM and 1PM to 4PM on Fridays. T4 Capacity Agreement Notices will be released Monday 19th April 2021.
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    ​​​​​​​Company Registrat​​ion Form

    ​​Please follow these steps to ensure successful registration. Please note, Safari and Google Chrome are not supported in the Registration process; we recommend using Internet Explorer or Firefox.

    1. Fill in the form below, completing all mandatory fields and ensuring the data is accurate.
    2. Click the "Submit" button at the bottom of the form; if you have filled all mandatory fields correctly you will be presented with a pop-up, click the "Save Form" button on this pop-up to download a copy of the registration document.
    3. Print the registration document on company letter headed paper.
    4. The Authorised Person must sign and date the registration document, once this is done scan it back to your computer.
    5. On submitting this form you will be sent an email with a link which you must use to upload the completed registration document, click the link and then follow the on screen instructions.
    6. Once your submission has been reviewed you will receive an email to inform you if your registration has been approved or rejected.
    7. If approved you will receive instructions informing you how to log on to the system, if rejected you will receive an explanation for the rejection.​​

    If you require further assistance with this process you can find detailed instructions in our ​EMR Company Registration  and user management guidance which can be found in the Prequalification section of the document library.

     

    Company Section
    Company Name *
    Company Registration Number
    Company Registration Type
    Address 1 *
    Address 2
    Address 3
    City/Town *
    Post code *
    Country *


    Authorised Person Section
    First Name *
    Last Name *
    Landline Number
    Email Address *
    Role/Position *
    Address 1 *
    Address 2
    Address 3
    City/Town *
    Post Code *
    Country *


    Main Company Admin User Section
    First Name *
    Last Name *
    Landline Number
    Country *
    Country Code *
    Mobile Number *
    Confirm Mobile Number *
    Email Address *
    Confirm Email Address *
    Address 1 *
    Address 2
    Address 3
    City/Town *
    Post Code *
    ​​
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